Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Rheumatology Department, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, Kings Lynn, UK.
Int J Rheum Dis. 2019 May;22(5):897-904. doi: 10.1111/1756-185X.13480. Epub 2019 Feb 6.
To determine the characteristics of individuals with hip and/or knee osteoarthritis who are recommended to seek physiotherapy or exercise treatment, and to explore which people are more or less likely to follow such recommendations.
All data were obtained from Wave 4 of the English Longitudinal Study of Ageing (ELSA) cohort (2008-2009), a prospectively collected community-based dataset. Eligibility was justified by a patient-reported diagnosis of hip and/or knee osteoarthritis with a visual analog scale (VAS) pain score of 1 or above. Data were collected from a self-completed questionnaire and nurse assessment visit. Prevalence of being recommended to physiotherapy or exercise (or not) and then the actioning of this recommendation (or not) were calculated and presented as 95% confidence intervals (CI). Data on characteristics of those recommended (or not) were explored using univariate analyses and then a forward selection logistic regression model.
In total, 1262 and 1877 individuals with hip and/or knee osteoarthritis pain were analyzed. This included 41% (95% CI: 0.38-0.44) who had been recommended to seek physiotherapy or exercise treatment. Subsequently, 83% of those recommended sought these treatments. Individuals who presented with isolated knee pain, those who reported "fair" self-reported general health and were younger had a greater chance of being recommended for physiotherapy or exercise treatment, respectively (P ≤ 0.02).
Encouragement should be given to formal and informal care providers of older people to highlight this inequality. This may then improve current and future access to evidence-based treatments for this population.
确定髋和/或膝关节骨关节炎患者中被推荐接受物理治疗或运动治疗的个体特征，并探讨哪些人更有可能或不太可能遵循这些建议。
所有数据均来自英国老龄化纵向研究（ELSA）队列的第 4 波（2008-2009 年），这是一个前瞻性收集的基于社区的数据集。通过患者自述的髋和/或膝关节骨关节炎诊断以及视觉模拟量表（VAS）疼痛评分 1 或以上来确定符合条件。数据来自自我完成的问卷和护士评估访问。计算了被推荐接受物理治疗或运动治疗（或不）以及随后是否采取这一建议（或不）的患病率，并以 95%置信区间（CI）表示。使用单变量分析和向前选择逻辑回归模型探讨了被推荐（或不）的个体的特征。
总共分析了 1262 名和 1877 名髋和/或膝关节骨关节炎疼痛患者。其中 41%（95%CI：0.38-0.44）被推荐寻求物理治疗或运动治疗。随后，83%的被推荐者寻求了这些治疗。仅出现膝关节疼痛的患者、报告“一般健康状况一般”的患者以及年龄较小的患者被推荐接受物理治疗或运动治疗的可能性更高（分别为 P ≤ 0.02）。
应鼓励老年人的正式和非正式护理提供者强调这种不平等现象。这可能会改善该人群目前和未来获得循证治疗的机会。
